Growing resistance to antibiotics is an emerging public health threat plaguing the world today. On Monday, the Kerala government kickstarted a mega, statewide campaign as part of its state action plan on addressing antimicrobial resistance.
Termed the Kerala Antimicrobial Resistance Strategic Action Plan (KARSAP), the campaign forms a key activity under the plan, which aims to raise public awareness better ways to use antibiotics and avoid resistance to these life saving drugs.
“The campaign aims to turn Kerala into an ‘antibiotics literate state’ by 2020. We want to spread awareness among the public on how to use this life-saving drug called antibiotics, how not to overuse them, how to dispose off expired drugs and prevent resistance to these drugs through better practices,” KL Sarala Devi, State Nodal head of KARSAP and HOD of the Microbiology department at the Thiruvananthapuram Medical College Hospital, told TNM.
In October 2018, Kerala became the first state to draw up a sub-national action plan on antimicrobial resistance (AMR), after recognising the need to address this emerging public health concern. KARSAP’s framework was drawn up by experts on the lines of the Global Action Plan on Antimicrobial Resistance and India’s action plan on antimicrobial resistance.
“These action plans focus on a 6-point strategic framework, which includes awareness and understanding, optimising the use of antibiotics and research and collaboration. We aim to take awareness to the public by teaching them how not to overuse antibiotics and develop resistance,” Dr Sarala Devi added.
The campaign was launched to coincide with the World Antibiotic Awareness Week (WAAW) from November 18-24.
What is antimicrobial resistance
Antimicrobial Resistance or AMR means that microbes or organisms which create diseases develop resistance to the antibiotics that are used to treat them.
“This doesn't just happens in human beings, it can happen among animals and poultry, expanding the risk of health hazards,” Dr Sarala Devi added.
Awareness and best practices
Dr Sarala Devi added that even before the official launch of the campaign, all staff members — from doctors and students to cleaners in government hospitals — were sensitised to best use practices for antibiotics.
“We create awareness drives among them. Students were trained to impart information to patient bystanders on the best ways to use antibiotics and how to prevent their misuse,” she added. The campaign will also take this knowledge to the public, including school children, to help them better understand the use of antibiotics. The campaign will target all, from the local self-government institutions to the grassroots level health care workers, to sensitise them and check antibiotic abuse, Dr Sarala added.
"A common mistake done by patients is to consume antibiotics for a viral common cold. Antibiotics cannot be used to treat 90 per cent of common colds and runny noses and hence unnecessary use of these drugs could increase risks of antimicrobial resistance," she said.
The action plan will also focus on the correct disposal of unused and expired antibiotic drugs.
“Improper disposal of antibiotics medicines into lakes, rivers and the soil also contributes to AMR. We are planning to set up boxes in all pharmacies with the public being instructed to hand over expired medicines back to the pharmacies. From here these drugs will be properly disposed off or incinerated,” she added.
Poultry farming is a known contributor to antimicrobial resistance which is in need of serious interventions.
"Poultry farms feed chicken with Colistin, an extremely powerful antibiotic drug used as a last measure by doctors to treat infections that are resistant to most drugs. Colistin is fed to the chickens to help them gain weight easily and remain resistant to diseases. This is later consumed by the people. The administration of antibiotics to chickens could lead to the creation of drug-resistant bacteria which could prove to be a major threat to public health,” Dr Sarala added.
However, since most poultry is imported to Kerala from neighbouring states, it is not within the powers of the state government to ban the use of Colistin in the poultry rearing industry, she said.
Prevention is the way forward
According to Dr Sarala, Infection Prevention Control Activities should be stepped up to ensure that antibiotics are not overused.
“Most government hospitals are overworked with double the number of patients than its full capacity. For this, the government is planning to provide better facilities in all tertiary centres including Primary Health Care Centres and Family Health Care Centres so that only the reference cases come to Medical Colleges. This way we can better control the spread of infections, reducing dependence on antibiotics,” she said.